The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endoscopic submucosal dissection of lower gastrointestinal lesions.

  • Description

    This procedure can be used to treat superficial colon lesions. The procedure involves inserting a long camera (colonoscope) through the anus as far as the caecum. A solution is injected submucosally to raise the area affected by the lesion, which is resected endoscopically.  The aim of the procedure is to fully remove the lesion without the need open surgery, and to obtain a good quality sample for histological examination.

  • OPCS4.6 Code(s)

    One of the following OPCS-4 codes is selected:


    H20.5 Fibreoptic endoscopic submucosal resection of lesion of colon


    H23.5 Endoscopic submucosal resection of lesion of lower bowel using fibreoptic sigmoidoscope


    H26.6 Endoscopic submucosal resection of lesion of sigmoid colon using rigid sigmoidoscope


    The NHS Classifications Service of the Health and Social Care Information Centre is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.  The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.


  • Get involved